LOWER BACK PAIN

Today in Learn Something New Madonna King spoke with physiotherapist Michael Ridgway from Baroona Physio on how to deal with back pain and how to prevent hurting your back in the first place.

As promised here are some of his tips

Low Back Pain and Referred Pain
Pain that is originating from the lower back can often be felt in adjacent areas of the body. This
‘radiating’ effect may result in pain being felt further up the back, in the legs, and even right down to
the feet!

Who is Affected?
Men and women are equally affected by low back pain. Whilst low back pain is experienced by all
age groups, from children through to the elderly, it occurs most often between ages 30 and 50. This
is due in part to the aging process, but is also a result of sedentary life styles with too little
(sometimes punctuated by too much) exercise (National Institute of Neurological Disorders &
Strokes—USA).

Common Causes of Low Back Pain
As people age, their bone strength, and muscle elasticity and tone tend to decrease. Adults with
back pain can have restricted movement in one or more directions and often experience some
muscle weakness. Whilst there are many factors/conditions that may contribute to low back pain,
some of the most common include:

1. A sedentary occupation involving prolonged sitting or driving
2. Poor abdominal muscle strength
3. Being inherently inflexible or hyperflexible
4. Injury or trauma to the back, or the build up of scar tissue from an old injury
5. Degenerative diseases such as arthritis and osteoporosis; and
6. Poor sleeping position, obesity, smoking, weight gain during pregnancy, stress, poor physical
condition, and posture inappropriate for the activity being performed.

Low Back Pain

Tips for Preventing Low Back Pain
For the overwhelming majority of people, low back pain will
be caused by muscle weakness in the back, abdomen, or
both. Here are some of the top tips for taking care of your
back and preventing low back pain:

1. Stay as active as possible and maintain a good level of
fitness and flexibility.
2. Maintain good posture. It is important to train yourself to recognise when you are slouching or
sitting too stiffly and causing tension in your muscles. (Refer to the BRP Fact Sheet on
Posture for more information about maintaining good posture).
3. Avoid sitting for periods longer than 20–30 minutes. Remember to regularly stand up and
move around. Whilst standing, arch your spine slowly backwards; we don’t normally move our
backs in that direction and as a result the ligaments involved can shorten.
4. Watch what you sit on! For example, men should avoid sitting on a flat wallet in their back
pocket; this can put pressure on the sciatic nerve.
5. Maintain good abdominal strength. This does not mean that you need to do hundreds of situps!
Many of your stomach muscles start in the back, so stomach muscles are a key factor in
maintaining the strength and stability of your back. A qualified physiotherapist will be able to
advise you on exercises specifically for the situation.
6. Consider your bag. For both children and adults the use of a backpack rather than a shoulder
bag will help distribute weight more evenly.
7. Learn preventative measures such as learning correct ways of bending and lifting, ensuring
that your work bench is at the correct height, using chairs with good support.
8. Try and relax. Your muscles get tight and sore when you are stressed. Learn some simple
relaxation exercises (like abdominal breathing) and incorporate them into your everyday
routine.
9. Maintain a healthy weight. Just carrying around a pot belly can throw extra pressure onto
your spine!
10. Prevention is always better than a cure! A qualified health professional, such as a
musculoskeletal physiotherapist , can tailor a back exercise programme specifically to your
needs. Doing these exercises regularly will help with strength, flexibility, and range of motion...
all the things you need in order to avoid low back pain!

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Comments

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As a doctor of musculoskeletal medicine I feel that I should correct some of the information posted here about the causes of back pain. I have prepared guidelines for the management of acute low back pain for the Royal Asutralian College of General Practitioners and in doing so I have examined the medical research extensively. Lets look objecively at the causes listed..
1. A sedentary occupation involving prolonged sitting or driving - ( no association found - there is soem evidence that exposure to whole body vibration may lead to pain )
2. Poor abdominal muscle strength - ( no evidence that this is a cause of pain )
3. Being inherently inflexible or hyperflexible - ( no evidence of a link between flexibility and pain )
4. Injury or trauma to the back, or the build up of scar tissue from an old injury - ( yes past trauma is strongly associated with pain )
5. Degenerative diseases such as arthritis and osteoporosis - (there is a poor correlation between degenerative changes seen on x-ray and the presence of pain. Oseoporosis may lead to fractures late in life )
6. Poor sleeping position ( no association ) , obesity ( yes weak evidence ), smoking ( yes strong evidence ), weight gain during pregnancy (uncertain) , stress ( no evidence ) , poor physical
condition ( yes ) , and posture inappropriate for the activity being performed ( no specific evidence ) .

The other statement following is also untrue...
"For the overwhelming majority of people, low back pain will be caused by muscle weakness in the back, abdomen, or both." (no evidence for this statement. Often muscle weakness will follow pain or injury - but muscle weakness has never been found to be a causative factor for back pain. It is true that a general strengthening program can help prevent or reduce future recurrences of pain )

It would be good to have a group in your local area that could get together and exercise, etc. I am only 44 and 5 years ago had a ruptured disc that required surgery. This frequently gets me down because I can now not do the things that I used to do and gyms are a waste of money for me because I cannot do a lot of the exercises. I am in the Redland Shire of Queensland and wondered if there were any groups that got together of other people with similar problems.